Sports Massage has many aspects. From pre-event warm-up massage to post-event cool-down massage, injury prevention to maintenance. Due to the lack of a national competency on Sports Massage, the consistency of sports massage delivery simply doesn’t exist in Australia. So, what types of Sports Massage should we be aware of and how are they administered? Let’s take a look at Pre-Event, Post-Event, Recovery, and Maintenance Sports Massage.
Pre-Event Sports Massage
Pre-Event sports massage generally takes place at the event site and within 20 minutes of the start of exercise. This would usually necessitate you being at the site of the exercise/sport. The general idea is to:
- Increase peripheral blood flow (warmth, oxygen, mobility) in the musculature of potential use.
- Stimulate neural activity (think of a sprinter slapping their thighs before a race) to the areas most likely to be used in the sport.
- Heighten awareness (bring the athlete ‘into the moment’).
- Potentially mobilise an area of known stiffness.
The massage should take place while the athlete is sitting up. When you lie down (and even more so when you close your eyes), your body produces particular blood constituents (your pineal gland releases the highest levels of melatonin when it’s dark or you close your eyes) that make you tired and sleepy. You would only ever do this (lay down with eyes closed) for those people who are over-excited or are involved in a sport that necessitates a calm demeanour, like archery.
The techniques should be light in depth but vigorous in nature. The vigorous action will increase peripheral heat and mobilise the connective tissues of the area treated, making them more mobile. The heat developed in vigorous massage helps ‘warm up’ the treated muscle groups, making them more prepared for activity and reducing potential injury.
Deep massage should be avoided in big prime mover muscles (the big muscles that create power like pecs and hamstrings) as this can potentially create a perception of loss of coordination or discomfort/pain (or both). The only time a prime mover should be massaged at depth in a pre-event massage is when there is a predetermined reason, such as an old scar from an injury or chronic tightness (always do this at training before attempting at a game so the athlete can feel the result).
For some sports where mobility is key (like swimming), using cupping (not prolonged static cupping but functional cupping) can give immediate fascial mobility without the negative effects of deep massage, like loss of proprioception or achey sensations. If you don’t have cups, you can simply grab the skin and superficial fascia, hold tight, and get the athlete to move through the ROM that they desire. It will sting briefly, but the results are generally excellent. They don’t tend to last long, but if done just prior to the event, the results will be sufficient.
Pre-event massages should generally last approximately 5-7 minutes and can incorporate some stretching if indicated.
Post-Event Massage
Post-event Massage is an attempt to restore the body to its pre-event state. In this circumstance, the athlete should be lying down to encourage blood back to the heart and out of the periphery. Don’t hesitate to use gravity as a means to encourage lower limb swelling recovery. Note that the athlete should always have performed their warm down prior to a post-event massage (usually a reduced effort of the same type of exercise – light jog if running, slow swimming if swim race, etc.). This is by far the best way to reduce lactic acid build-up and reduce muscle soreness. Post-event massage has little effect on lactic acid removal (some evidence suggests it helps a little bit); hence, the athlete needs to perform their post-event warm down prior to massage to reduce any negative excessive lactic effects.
Post-event massage is generally a broad-handed rhythmical massage (and sometimes static digital pressure for trigger point development or areas of increased tone if that has occurred) that looks to address:
- A reduction in peripheral swelling caused by exercise.
- Reduction in neuromuscular activity (calm down the over-excited nervous system).
- Reduction in muscle tone that has increased during exercise. This may include cramps.
- Restoration of range of motion. This may include light stretching.
Anecdotally, the athlete suggests:
- A decrease in the feeling of ‘heaviness’.
- Reduction in pain or discomfort.
- Greater mobility.
All these are very difficult to measure as it is often the athlete’s perception rather than a quantitative event (measurable). Hence there is limited scientific evidence, although the anecdotal evidence is strong.
The techniques used during this type of massage are generally light and slow. Focus on swelling in lower limbs (broad-handed slow techniques towards the centre of the body), slow MTJ ‘drags’ (pressure on the MTJ and slowly drag away from the attachment – this often helps reduce excessive muscle tone and the perception of ‘tightness’) to reduce tone, light jostling about joints that reduce tone (reduce alpha motor neuron excitability), maybe some trigger points if this is indicated, and definitely light, repetitive stretching.
Please note, it is very important to emphasise the importance of the athlete doing their own cool down prior to a post-event massage. This is by far the most important and effective part of the protocol, especially regarding reducing lactic acid accumulation. Lactic Acid will clear within 60 minutes even if you do nothing, but there are theories that this timeframe may lead to muscle soreness and lack of muscle health. By doing their own cool down (same exercise but a lot lighter/slower), they will remove lactic acid much quicker. Then a post-event massage will finish them off!
Maintenance Massage
Maintenance massage is the most sought-after type of sports massage in the clinical setting. It is also the most sought-after type of massage that a travelling sports team will ask for and what will be delivered at most professional sporting teams during the week. They generally focus on recovery of particular areas of the body (depending on the sport and the athlete), injury prevention (to known areas of concern – especially those that have undergone a ‘screening’ – discussed later), and performance (areas of known concern that reduced the athlete performing at their highest level – like thoracic mobility and swimming).
Importantly, the athlete should have a predetermined idea of what they want/need out of the session and make sure that is passed on to the therapist. Due to a lack of consistent education in sports massage across the country, there isn’t a well-versed protocol that young therapists can draw from. Each individual therapist, town, region, sport, etc., may have their own idea of what should occur during a ‘sports massage’. This inconsistency proves difficult for the athlete who moves around, using multiple therapists. Hence, your communication prior to the session is very important. You must ask enough questions to garner what they expect out of the session.
This is what I often tell a budding athlete to consider when seeking a ‘maintenance Sports Massage’:
“If you are unsure of what you are after in a sports massage, then make sure you ask the therapist what they believe is best for your current situation (stiffness, soreness, heaviness, pre-major event, etc). Please don’t just jump on the table and expect exactly what you are after as there are plenty of different types of maintenance sports massage possibilities and a good relationship between the therapist and athlete is essential (and often with the coach, physio, and strength and conditioning staff if in an elite setting). Hence, if you are after a broad-handed rhythmical type sports massage (often called a ‘flush’), then you need to suggest this. If you want it light, then tell the therapist (they should ask you anyway); if you want light on the calves, heavy on the hammies, and some range of motion stuff around the hips, then ask for this. If you have no idea what you want or need, then ask the therapist their opinion on what would be best for you and why.”
For experienced athletes who are travelling:
“Take a brief dot point letter from your usual therapist with what works for you. Techniques, areas to focus on, what to assess and monitor.”
Providing a sports maintenance massage isn’t just using remedial techniques on an athlete or doing what you usually do but it just happens to be in a sporting environment. Your strategy and indication for techniques needs to meet their needs and the needs of their particular sport. Knowing the sport is obviously a massive bonus as you will have fundamental knowledge on what injuries they are more likely to sustain, what type of workload they encounter, what type of ROM that particular sport demands, etc. If you don’t know this, you will be guessing. Guessing isn’t what the athlete is after. Get to know your sport. Being very objective about providing an intervention for particular sports is what turns a ‘general remedial massage’ into a sports maintenance massage.
In summary, what should you consider before a maintenance sports massage (not a general flush for those 2-3 days post-event with general soreness)?
- What is their sport? Sport-specific muscle groups and ROM are very important. Runners will often ask for calf ROM, ITB issues, hip soreness, lower back ache. Swimmers will ask for mid-back mobilisation, shoulder ROM, etc.
- Know their current training status. If they are in a big training block, then you may need to split the session into a flush (general light recovery) and then sport-specific ROM recovery. If they are pre-event (within a week), then they generally are after lighter work and for you to assess and treat any niggles that you find – but not aggressively, as this may cause issues just prior to a major event.
- Do they have current or pre-existing injuries, or areas of chronic or acute tightness? Many athletes, especially the older group, will have a long history of injuries and ongoing areas of concern. They will know them, they all do. You need to ask what these are and also what has worked for them in the past. Try to emulate techniques that have worked via other therapists. Call their physio, doc, or strength and conditioning coach if you want more information.
- If they have any sport performance issues. You will need to know the sport to understand what factors lead to greater performance (like the necessity for Thoracic mobility for swimming as a simple example). This often means being associated with a sport and spending quite a bit of time with the coaches and other staff to gain expert knowledge on the area.
- Screening. A sports screening is a predetermined set of assessments that are necessary for that particular sport's performance and injury prevention. Ask the athlete if they have one and read it. It will fast-track your protocol setting for that particular athlete. A screening will show you areas of assessed ROM issues and weaknesses that lead to performance and injury vulnerability.
The techniques used in sports massage can range from multiple types of stretching and light strokes (flush) to deeper strokes, trigger point work, fascial mobilisation, and even dry needling and cupping in particular circumstances. Be sure to ask the athlete if they prefer particular techniques for certain areas of their body. They are a picky bunch. They know what they like, but you will have to ask them. Otherwise, you get a bad review on Google!
Sports Massage is a very broad area. It is generally misunderstood by athletes, coaches, other medical staff, and even therapists! Knowing the sport you are working with is paramount. Since every sport differs, you need to adapt to provide the best experience and results for your athletes.
Equipping Yourself for Success
Of course, delivering a great sports massage isn't just about technique—it's also about the tools you trust.
Whether it’s the invigorating scent and superior grip of MWax Sport for pre-event mobilisation, or the cooling relief of MWax Recover for post-event care, having the right medium in your kit makes all the difference.
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